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What Poisoned Bihar Schoolchildren?

A child who fell ill after eating a free meal at a school in Bihar, rested at a hospital in Patna, July 18.

Officials say initial investigations show the food that killed at least 23 children from a school in the eastern Indian state of Bihar was contaminated with organophosphorus.

Organophosphorus compounds or organophosphates form a group of chemicals with a variety of uses, from crop protection to chemical warfare.

India Real Time asked Rama Rao, director of Medical Toxicology at the Weill Cornell Medical Center in New York’s Presbyterian Hospital, to explain how organophosphates are used and what impact exposure can have on health.

In an emailed reply, Ms. Rao said organophosphates are used as pesticides and are readily available in high concentrations in developing countries. Exposure to these agents, particularly when ingested, affects part of the nervous system and causes vomiting, diarrhea, a slow heart rate, fluid in the lungs, seizures and severe muscular weakness that can lead to respiratory failure, she said.

The schoolchildren who became sick in Bihar suffered from vomiting, fainting and foaming at the mouth soon after eating contaminated food. More than two dozen children, as well as the school cook, remain in a hospital in the state capital. Amarkant Jha Amar, medical superintendent at the hospital, said patients have been given medicine to neutralize the effect of organophosphorus exposure.

“There have been many cases of pesticide contaminated foods in history. These episodes… almost invariably involve impoverished persons who are vended dubiously prepared products, or who, out of sheer desperation, prematurely use contaminated agricultural products to avoid starvation,” Ms. Rao said.

“Children weigh less and are likely to succumb faster to the same dose of poison,” she said.

Ms. Rao added that organophosphates are one of the most common methods of suicide in developing nations, where highly concentrated products are readily available and less regulated than in developed nations.

“With regards to poisoning deaths, this is a terrible public health problem in India and much of Southeast Asia and could be diminished by reducing its ready availability,” she said.

Some organophosphates are also used for other purposes such as nerve agents in chemical weapons, Ms. Rao added.

Abhijit Sinha, a district magistrate in Bihar, said Thursday that a container of mustard oil used in cooking at the school where the children were taken ill could have previously stored pesticides.

“But what makes us wonder is whether small traces of contamination could lead to such violent reactions,” he said, adding that a clearer picture should emerge when the forensic report is made available, likely Thursday evening.